DESCRIPTION: The center of apparel manufacturing in the United States is California with approximately 7,500 apparel firms and the Los Angeles basin accounting for 80% (115,000 jobs) of California's apparel and textile industry. Nearly 40% of the industries with the highest reported incidence rates of injuries and illnesses from repetitive motion in the United States are in apparel manufacturing. Thus, we are proposing to conduct a randomized trial of a newly developed ergonomic intervention applied to sewing machine operators working in LA garment shops; we tested these interventions previously for acceptance by workers in Northern California. The proposed ergonomic intervention package includes changes in work station design such as 1) tilting the sewing machine table to decrease neck and trunk flexion; 2) seating improvements such as adding sitting wedges to existing chairs and/or providing highly adjustable chairs appropriate selected for work at a sewing machine; 3) installing table extension on the left side of the sewing machine table to decrease awkward arm postures and pinch forces; and 4) providing support for the left foot with a simple block of wood or extending the foot pedals so that both feet are well supported, or activate, the control. In addition to equipment changes, we will train all employees in how to perform work tasks more safely, and/or suggest improvements in the work procedures (e.g., redesign of the work flow, rest breaks, enhanced variety in tasks to reduce repetitive strain). We will examine whether interventions implemented at 150 sewing work station and expected to have benefits can reduce rates of upper extremity, neck (and lower back) musculoskeletal disorders, severity of pain and impairment, and lost-time compared to 150 'placebo' (control) interventions. Secondary purposes include (1) determining the effect of the intervention on body postures and work practices, (2) identifying the characteristics of employees, who benefit from the intervention, (3) estimating the effects of the intervention on productivity, and (4) estimating the cost of the intervention. The long-term objectives of this line of research are to determine to what extent ergonomic and some work organizational changes (for sewing machine operators in garment shops can prevent upper extremity, neck and low back musculoskeletal impairment, disorders, and disability. This study will provide employers, employees and public agencies with evidence of the effectiveness of ergonomic interventions in order to guide health and safety policy.